THE DIFFERENT CLINICAL FORMS 1.2. Shapes according to age 1.2.1. Latency phase depression: depression in school-age children Often occurring following an event representing loss or bereavement (separation of parents, death of a grandparent, a member of siblings or a parent), sometimes an event which may appear to adults appear more innocuous (moving, death of a pet, etc.), depression in children often sets in gradually with symptoms belonging to several registers. The great clinical polymorphism at this age gives depression a misleading appearance. However, the child's behavior appears clearly modified compared to his premorbid state. The clinical picture combines several symptoms in the following registers: Sadness of mood and boredom: sadness is often replaced by attacks of anger, or even lability of mood. Irritability often takes the form of anger or opposition. Devaluation and loss of self-esteem : We note an exacerbated sensitivity to imperfections and/or failures. Child's activities are often accompanied by negative comments, self-deprecation, and/or a feeling of inadequacy and worthlessness. Loss of interest and pleasure: are rather manifested by attitudes of withdrawal, disinterest, passivity: in the depressed child there is a loss of interest in some or all of the activities which could be a source of pleasure for him. Motor behavior disorders : most often, we notice instability or agitation. Psychomotor slowing and motor inhibition are much rarer. Academic difficulties: Attentional and memory difficulties can lead to decline or even academic failure. They must be mentioned in the face of secondary avoidance or refusal of school work. Repeated somatic complaints type of abdominal pain and headaches which may precede the symptoms and for which no organic cause is found. Conduct disorder : type of lies, theft, hetero-aggression, even running away.
Suicidal ideation and equivalents: depressed children have a marked propensity for fractures, accidents and injuries. These manifestations can be considered suicidal equivalents. Sometimes, ideas of death or suicide can be expressed directly or manifest themselves more rarely, through a suicidal act which should never be underestimated. Appetite disorders : type of anorexia, snacking or hyperphagia. Sleep disorders : They vary from insomnia to falling asleep, refusal to go to bed, broken sleep and/or nightmares. Sphincter disorders : type of secondary encopresis and/or secondary enuresis. The positive diagnosis is based on history, family interview and clinical examination. Each of these signs taken in isolation is not necessarily indicative of the depressive episode. It is the association of at least five of the symptoms (with at least one of the symptoms is either the change in mood or the loss of interest or pleasure), their permanence in time (for at least two weeks) and the modification net behavioral that they induce in relation to the behavior prior, which is characteristicand which will make it possible to diagnose depression in children.